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Pharmacotherapy of Social Phobia

A Controlled Study with Moclobemide and Phenelzine

Published online by Cambridge University Press:  02 January 2018

M. Versiani*
Affiliation:
Institute of Psychiatry, Federal University of Rio de Janeiro
A. E. Nardi
Affiliation:
Institute of Psychiatry, Federal University of Rio de Janeiro
F. D. Mundim
Affiliation:
Institute of Psychiatry, Federal University of Rio de Janeiro
A. B. Alves
Affiliation:
Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, Brazil
M. R. Liebowitz
Affiliation:
New York State Psychiatric Institute and Department of Clinical Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
R. Amrein
Affiliation:
4002 Basle, Switzerland
*
Av. N. Sa. Copacabana, 1133/1303, CEP 22070, Rio de Janeiro-RJ, Brazil

Abstract

In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs – phenelzine somewhat more than moclobemide – were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs.

Type
Papers
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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References

Amies, P. L., Gelder, M. G. & Shan, P. M. (1983) Social phobia: a comparative clinical study. British Journal of Psychiatry, 142, 174179.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baldessarini, R. J. (1989) Current status of antidepressants: clinical pharmacology therapy. Journal of Clinical Psychiatry, 50, 117126.Google Scholar
Baumhackl, U., Biziere, K., Fischbach, F., et al (1989) Efficacy and tolerability of moclobemide compared with imipramine in depressive disorder (DSM–III): an Austrian double-blind, multi centre study. British Journal of Psychiatry, 155 (suppl. 6): 7883.CrossRefGoogle Scholar
Brady, J. P. (1984a) Social skills training for psychiatric patients: international concepts, methods and clinical results. American Journal of Psychiatry, 141, 333340.Google Scholar
Brady, J. P. (1964b) Social skills training for psychiatric patients: II. Clinical outcome studies. American Journal of Psychiatry, 141, 491498.Google Scholar
Callingham, B. A. & Ovens, R. S. (1987) Some in vitro effects of moclobemide and other MAO inhibitors on responses to sympathomimetic amines. Journal of Neural Transmission, 26, 1729.Google Scholar
Derogatis, L. R., Lipman, R. S. & Covi, L. (1973) SCL–90: An out patient psychiatric rating scale. Psychopharmacological Bulletin, 9, 1328.Google Scholar
Emmelkamp, P. M. G. (1982) Phobic and Obsessive–Compulsive Disorder: Theory, Research and Practice. New York: Plenum Press.Google Scholar
Finberg, J. P. M. & Youdim, M. B. H. (1987) Potentiation of tyramine pressor responses in conscious rats by reversible inhibitors of monoamine oxidase. Journal of Neural Transmission, 26, 1116.Google Scholar
Gieschke, R., Schmid-Burgk, W. & Amrein, R. (1987) Interaction of moclobemide, a new reversible monoamine oxidase inhibitor with oral tyramine. Journal of Neural Transmission, 26, 97104.Google Scholar
Goldstein, S. (1987) Treatment of social phobia with clonidine. Biological Psychiatry, 22, 369372.Google Scholar
Gorman, J. M., Liebowitz, M. R., Fyer, A. J., et al (1985) Treatment of social phobia with atenolol. Journal of Clinical Psychopharmacology, 5, 298301.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology, revised. Rockville, Maryland: US Dept of Health, Education and Welfare.Google Scholar
Hamilton, M. (1959) The assessment of anxiety scales by rating. British Journal of Medical Psychology, 32, 5055.CrossRefGoogle Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.CrossRefGoogle ScholarPubMed
Heinze, G. & Sanchez, A. (1987) El moclobemide en lo tratamiento de la depression. Salud Mental, 10, 2935.Google Scholar
Klein, D. (1983) Is the antipanic activity of antidepressant medication a reflection of antidepressant effects? Integrative Psychiatry, 1, 2627.Google Scholar
Larsen, J. K., Holm, P. & Mikkelsen, P. L. (1984) Moclobemide and clomipramine in the treatment of depression. Acta Psychiatrica Scandinavica, 70, 252260.Google Scholar
Liebowitz, M. R., Gorman, J. M., Fyer, A. J., et al (1985) Social phobia. Review of a neglected anxiety disorder. Archives of General Psychiatry, 42, 729736.CrossRefGoogle ScholarPubMed
Liebowitz, M. R., Fyer, A. J., Gorman, J. M., et al (1986) Phenelzine in social phobia. Journal of Clinical Psychopharmacology, 6, 9398.Google Scholar
Liebowitz, M. R., Gorman, J. M., Fyer, A. J., et al (1988) Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol. Journal of Clinical Psychiatry, 49, 252257.Google Scholar
Lydiard, R. B., Laraia, M. T., Howell, E. D., et al (1988) Alprazolam in the treatment of social phobia. Journal of Clinical Psychiatry, 49, 1719.Google Scholar
Marks, I. M. (1981) Cure and Care of Neurosis. New York: Wiley.Google Scholar
Mountjoy, C. Q., Roth, M., Garside, R. F., et al (1977) A clinical trial of phenelzine in anxiety depressive and phobic neuroses. British Journal Psychiatry, 131, 486492.Google Scholar
Munjack, D. J., Baltazar, P. L., Bohn, P. B., et al (1990) Clonazepam in the treatment of social phobia: a pilot study. Journal of Clinical Psychiatry, 51 (suppl. 5): 3540.Google Scholar
Norman, T. R., Ames, D. & Burrows, G. D. (1985) A controlled study of a specific MAO-A reversible inhibitor and amitriptyline in depressive illness. Journal of Affective Disorders, 8, 2938.CrossRefGoogle ScholarPubMed
Ost, L. G., Jerremalm, A. & Johanson, J. (1980) Individual response patterns and the effects of different behavioural methods in the treatment of social phobia. Behavioural Research and Therapy, 19, 116.CrossRefGoogle Scholar
Sheehan, D. (1984) In The Anxiety Disease, pp. 148149. New York: Scribner.Google Scholar
Solyom, C., Solyom, L., Lapierre, Y., et at (1981) Phenelzine and exposure in the treatment of phobia. Biological Psychiatry, 16, 239247.Google Scholar
Solyom, C., Heseltine, G. F. D., McClure, D. J., et al (1973) Behavior therapy versus drug therapy in the treatment of phobic neurosis. Canadian Journal of Psychiatry, 18, 2531.Google Scholar
Solyom, C., Ledwige, B. & Solyom, C. (1986) Delimiting social phobia. British Journal of Psychiatry, 149, 464470.CrossRefGoogle Scholar
Spitzer, R., Williams, J. B. & Gibbon, M. (1987) Structured Clinical Interview of DSM–III–R (SCID I and II). Biometrics Research Department, New York Psychiatric Institute.Google Scholar
Stabl, M., Biziere, K., Schmid-Burgk, W., et al (1989) Review of comparative clinical trials: moclobemide vs tricyclic antidepressants and vs placebo in depressive states. Journal of Neural Transmission, (suppl. 28), 7790.Google Scholar
Stefanis, C. N., Alevizos, B. & Papadimitriou, M. (1984) Controlled clinical study of moclobemide. A new MAO inhibitor and desipramine in depressive patients. In Monoamine Oxidase and Disease (ed. Tipton, K. F.). London: Academic Press.Google Scholar
Stravynski, A. & Shahar, A. (1983) The treatment of social dysfunction in nonpsychotic outpatients: a review. Journal of Nervous and Mental Disease, 171, 721728.CrossRefGoogle ScholarPubMed
Tyrer, P. J., Candy, J. & Jelly, D. (1973) A study of the clinical effects of phenelzine and placebo in the treatment of phobic anxiety. Psychopharmacology, 32, 237254.CrossRefGoogle ScholarPubMed
Versiani, M. (1990) Social phobia and pharmacotherapy. Human Psychopharmacology, 5, 103104.CrossRefGoogle Scholar
Versiani, M., Mundim, F. D., Nardi, A. E., et al (1988) Tranylcypromine in social phobia. Journal of Clinical Psychopharmacology, 8, 279283.CrossRefGoogle ScholarPubMed
Versiani, M., Nardi, A. E. & Mundim, F. D. (1989a) Fobia social. Jornal Brasileiro de Psiquiatria, 38, 251263.Google Scholar
Versiani, M., Oggero, U., Alterwain, P., et al (1989b) A double-blind comparative trial of moclobemide vs imipramine and placebo in major depressive episodes. British Journal of Psychiatry, 155 (suppl. 6): 7277.Google Scholar
Versiani, M., Nardi, A. E., Figueira, I. L. V., et al (1990) Tolerability of moclobemide, a new reversible inhibitor of monoamine oxidase-A, compared with other antidepressants and placebo. Acta Psychiatrica Scandinavica, (suppl. 360), 2428.CrossRefGoogle Scholar
Watson, D. & Friend, R. (1969) Measurement of social–evaluative anxiety. Journal of Consulting and Clinical Psychology, 33, 448457.Google Scholar
Willouohby, R. R. (1932) Some properties of the Thurstone Personality Schedule and a suggested revision. Journal of Social Psychology, 3, 401424.CrossRefGoogle Scholar
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